Organization
MEDICAL SUPPLY OUTLET, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENEANE HALEY (PRESIDENT)
(310) 671-3522
Entity
Organization
Contact information
Practice address
105 E 64TH PL, INGLEWOOD, CA 90302-1338
(310) 671-3522
(310) 671-3622
Mailing address
105 E 64TH PL, INGLEWOOD, CA 90302-1338
(310) 671-3522
(310) 671-3622
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
44751
CA
Other
Enumeration date
10/29/2007
Last updated
10/29/2007
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